Work interrupted: A comparison of workplace interruptions in emergency departments and primary care offices

Study objective: We sought to determine the number of interruptions and to characterize tasks performed in emergency departments compared with those p erformed in primary care off ices. Methods: We conducted an observational time-motion, task-analysis study in 5 nonteaching community hospitals and 22 primary care offices in 5 central Indiana cities. Twenty-two emergency physicians and 22 office-based primary care physicians (PCPs) were observed at work. The number of interruptions, tasks, simultaneous tasks, and patients concurrently managed were recorded in 1-minute increments during 150- to 210-minute observation periods. Results: Emergency physicians were interrupted an average of 9.7 times per hour compared with 3.9 times per hour for PUS, for an average difference of 5.8 times per hour (95% confidence interval [Cl] 4.2 to 7.4). PCPs spent a n average of 11.4 minutes per hour performing simultaneous tasks compared w ith 6.4 minutes per hour for emergency physicians (average difference, 5.0 minutes; 95% Cl 12 to 8.8). Emergency physicians spent an average of 37.5 m inutes per hour managing 3 or more patients concurrently compared with 0.9 minutes per hour for PCPs. PCPs spent significantly more time performing di rect patient care, and emergency physicians spent significantly more time i n analyzing data, charting, and taking reports on patients. Conclusion: Emergency physicians experienced more interruptions and managed more patients concurrently than PCPs. PCPs spent more time performing simu ltaneous tasks than emergency physicians. Our study suggests there are impo rtant ergonomic differences between emergency medicine and off ice-based pr imary care work environments that may require different training approaches , design considerations, and coping strategies.